Patient Protection and Affordable Care Act will require healthcare providers to coordinate care better to improve population health and reduce the number of avoidable ER visits, hospitalizations and readmissions. Patient-centered health information exchanges (HIEs) that provide actionable, real-time information to clinicians and that engage patients in their own care are necessary to achieve these goals. Unfortunately, most of the federally funded, state- managed HIE programs are at risk of missing the boat by emphasizing large-scale statewide or regional connectivity rather than focusing on meeting local needs. In many states, the state-designated HIE&#38;#x2019;s focus is on ensuring that ER physicians can obtain care summaries for patients from other communities who come to their ERs.

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That can be useful in some circumstances, but what health system physicians need most for care coordination is data about the patients in their own areas and the ability to exchange data about those patients throughout their health system and with the patient directly. To fi ll this gap, systems across the country are building their own private HIEs to connect their health systems together and to link with their staff physicians and patients. Some of these HIEs are adding EHR capabilities as well to

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enable their physicians, who don&#38;#x2019;t already have an EHR, to qualify for meaningful use. Healthcare system-based HIEs also provide the foundation for the development of patient-centered medical homes and ACOs. They will aid providers in demonstrating meaningful use, particularly in Stages 2 and 3 of the government incentive program for EHR users. Similarly, when standards are in place for connecting community and private HIEs together, connectivity will be more prevalent across the country. However, none of these efforts will produce the desired outcomes unless the patient is actively involved at every stage.

The Webcam moves from connecting people to connecting care

By Alan Roga, M.D., chairman and CEO, Stat Health Services

In 2011, the Webcam will be used to fuel the high-tech, high-growth telemedicine industry. Telemedicine stands to fi ll a multitude of gaps in healthcare delivery and simultaneously improve care and health outcomes in convenient and cost-effective ways. Until now, telemedicine had primarily served rural populations. With the prevalence of smartphones, the availability of more sophisticated technologies (such as video conferencing) and the push toward digitizing medical records and promoting interoperability, telemedicine moves into mainstream healthcare and will prove to be indispensible in contributing to our national health-reform goals of improving the cost, quality and accessibility of healthcare. And consumer demand for the same online, anytime, anywhere conveniences enjoyed in nearly every other aspect of life, from banking to shopping and connecting with friends, will support adoption and broad

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utilization of telemedicine services.

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With a shortage of primary care physicians and the unlikely prospect of getting a same- day appointment when the need arises, patients all too often resort to the emergency room and urgent care centers as a primary means of accessing medical care. While new care delivery models are being piloted, no one model will fi x the system, be adopted universally and meet the needs of all healthcare stakeholders. Telemedicine offers a viable

alternative for physicians and patients to coordinate care, despite an ineffi cient healthcare delivery system. eHealth innovations (such as online doctor visits or e-visits) using a smartphone&#38;#x2019;s Webcam will transform the healthcare experience. eHealth can help support the needs of rural populations, provide care to patients who couldn&#38;#x2019;t afford the time away from work or family, promote wellness, get people the care they need before they become costly users and effectively fi ll unaddressed gaps in healthcare delivery with quality, convenient and cost- effective care. And the value of Webcams will come full circle, enabling physicians and consumers to coordinate care when it&#38;#x2019;s needed and in real time, preserving health, wellness and valuable time with their families.